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AUTUMN HILLS OF BEMIDJI, INC.
NPI 1619199916
Assisted Living Facility in Bemidji, MN

Active since May 03, 2007CLIA 24D1059524 · Waiver
2528 PARK AVE NW, BEMIDJI, MN 56601(218) 333-3854(218) 333-3855 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Autumn Hills Of Bemidji, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AUTUMN HILLS OF BEMIDJI, INC. (NPI 1619199916) is a healthcare organization registered as an assisted living facility in Bemidji, Minnesota and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through October 1, 2026 and lists Shelley Jean Cloose, President, as its authorized official.

NPPES Registry Identity

NPI1619199916
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameAUTUMN HILLS OF BEMIDJI, INC.
Location Address2528 PARK AVE NWBemidji, MN 56601
Mailing Address2528 Park Ave NwBemidji, MN 56601 · (218) 333-3854 · Fax (218) 333-3855
Phone(218) 333-3854
Fax(218) 333-3855
Organization SubpartNo
Authorized OfficialShelley Jean CloosePresident · (218) 333-3854
Enumeration DateMay 3, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1619199916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MN · 332829
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
2528 PARK AVE NW, Bemidji, MN 56601
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D1059524

Autumn Hill Of Bemidji Inc · Bemidji, MN
Active · expires Oct 1, 2026
CLIA Number24D1059524
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 2, 2024
Certificate Expiration DateOctober 1, 2026
Laboratory DirectorShelly J. Cloose
Laboratory Phone(218) 333-3854
Laboratory LocationAutumn Hill Of Bemidji Inc2528 Park Ave NW, Bemidji, MN 56601
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MIDWEST CARE FACILITIES LLC
Assisted Living Facility
2528 PARK AVE NW
BEMIDJI, MN 56601
Beltrami County (218) 333-3854
AUTUMN HILLS OF BEMIDJI, INC.
Home Health
2528 PARK AVE NW
BEMIDJI, MN 56601
Beltrami County (218) 333-3854

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Autumn Hills Of Bemidji, Inc.'s NPI number?

The NPI number for Autumn Hills Of Bemidji, Inc. is 1619199916. It was assigned to this organization in the NPPES registry on May 3, 2007.

Where is Autumn Hills Of Bemidji, Inc. located?

Autumn Hills Of Bemidji, Inc. is located at 2528 Park Ave NW, Bemidji, MN 56601. The listed phone number is (218) 333-3854.

What is Autumn Hills Of Bemidji, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Autumn Hills Of Bemidji, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D1059524) is associated with this NPI, valid through October 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Autumn Hills Of Bemidji, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.